Document Detail

Manual therapy in addition to physiotherapy does not improve clinical or economic outcomes after ankle fracture.
MedLine Citation:
PMID:  18509557     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The primary aim of this study was to determine the effectiveness and cost-effectiveness of adding manual therapy to a physiotherapy programme for ankle fracture.
DESIGN: Assessor-blinded randomized controlled trial.
PARTICIPANTS: Ninety-four adults were recruited within one week of cast removal for isolated ankle fracture. Inclusion criteria were: they were able to weight-bear as tolerated or partial weight-bear, were referred for physiotherapy, and experienced pain. Ninety-one participants completed the study.
METHODS: Participants were randomly allocated to receive manual therapy (anterior-posterior joint mobilization over the talus) plus a standard physiotherapy programme (experimental), or the standard physiotherapy programme only (control). They were assessed by a blinded assessor at baseline, and at 4, 12 and 24 weeks. The main outcomes were activity limitation and quality of life. Information on costs and healthcare utilization was collected every 4 weeks up to 24 weeks.
RESULTS: There were no clinically worthwhile differences in activity limitation or quality of life between groups at any time-point. There was also no between-group difference in quality-adjusted life-years, but the experimental group incurred higher out-of-pocket costs (mean between-group difference = AU$200, 95% confidence interval 26-432).
CONCLUSION: When provided in addition to a physiotherapy programme, manual therapy did not enhance outcome in adults after ankle fracture.
Chung-Wei Christine Lin; Anne M Moseley; Marion Haas; Kathryn M Refshauge; Robert D Herbert
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of rehabilitation medicine     Volume:  40     ISSN:  1650-1977     ISO Abbreviation:  J Rehabil Med     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-05-29     Completed Date:  2008-06-24     Revised Date:  2014-05-30    
Medline Journal Info:
Nlm Unique ID:  101088169     Medline TA:  J Rehabil Med     Country:  Sweden    
Other Details:
Languages:  eng     Pagination:  433-9     Citation Subset:  IM    
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MeSH Terms
Ankle Injuries / economics,  psychology,  rehabilitation*
Cost of Illness
Cost-Benefit Analysis
Follow-Up Studies
Fractures, Bone / economics,  psychology,  rehabilitation*
Health Care Costs
Musculoskeletal Manipulations / methods*
Outcome Assessment (Health Care)
Pain Measurement
Physical Therapy Modalities*
Quality of Life
Recovery of Function
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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